Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.

<h4>Background</h4>Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to...

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Main Authors: Euan Sadler, Talya Porat, Iain Marshall, Uy Hoang, Vasa Curcin, Charles D A Wolfe, Christopher McKevitt
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0177102&type=printable
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author Euan Sadler
Talya Porat
Iain Marshall
Uy Hoang
Vasa Curcin
Charles D A Wolfe
Christopher McKevitt
author_facet Euan Sadler
Talya Porat
Iain Marshall
Uy Hoang
Vasa Curcin
Charles D A Wolfe
Christopher McKevitt
author_sort Euan Sadler
collection DOAJ
description <h4>Background</h4>Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to improve healthcare. A 'Learning Health System' (LHS) is an innovative model of care which transforms integrated data into knowledge to improve healthcare. The objective of this study is to develop a process of engaging stakeholders in the use of clinical and research data to co-produce potential solutions, informed by a LHS, to improve long-term care for stroke survivors with multimorbidity.<h4>Methods</h4>We used a stakeholder engagement study design informed by co-production principles to engage stakeholders, including service users, carers, general practitioners and other health and social care professionals, service managers, commissioners of services, policy makers, third sector representatives and researchers. Over a 10 month period we used a range of methods including stakeholder group meetings, focus groups, nominal group techniques (priority setting and consensus building) and interviews. Qualitative data were recorded, transcribed and analysed thematically.<h4>Results</h4>37 participants took part in the study. The concept of how data might drive intervention development was difficult to convey and understand. The engagement process led to four priority areas for needs for data and information being identified by stakeholders: 1) improving continuity of care; 2) improving management of mental health consequences; 3) better access to health and social care; and 4) targeting multiple risk factors. These priorities informed preliminary design interventions. The final choice of intervention was agreed by consensus, informed by consideration of the gap in evidence and local service provision, and availability of robust data. This shaped a co-produced decision support tool to improve secondary prevention after stroke for further development.<h4>Conclusions</h4>Stakeholder engagement to identify data-driven solutions is feasible but requires resources. While a number of potential interventions were identified, the final choice rested not just on stakeholder priorities but also on data availability. Further work is required to evaluate the impact and implementation of data-driven interventions for long-term stroke survivors.
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spelling doaj-art-c9ed32c8e0854fb6a29ee4006a590c8a2025-08-20T03:26:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01125e017710210.1371/journal.pone.0177102Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.Euan SadlerTalya PoratIain MarshallUy HoangVasa CurcinCharles D A WolfeChristopher McKevitt<h4>Background</h4>Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to improve healthcare. A 'Learning Health System' (LHS) is an innovative model of care which transforms integrated data into knowledge to improve healthcare. The objective of this study is to develop a process of engaging stakeholders in the use of clinical and research data to co-produce potential solutions, informed by a LHS, to improve long-term care for stroke survivors with multimorbidity.<h4>Methods</h4>We used a stakeholder engagement study design informed by co-production principles to engage stakeholders, including service users, carers, general practitioners and other health and social care professionals, service managers, commissioners of services, policy makers, third sector representatives and researchers. Over a 10 month period we used a range of methods including stakeholder group meetings, focus groups, nominal group techniques (priority setting and consensus building) and interviews. Qualitative data were recorded, transcribed and analysed thematically.<h4>Results</h4>37 participants took part in the study. The concept of how data might drive intervention development was difficult to convey and understand. The engagement process led to four priority areas for needs for data and information being identified by stakeholders: 1) improving continuity of care; 2) improving management of mental health consequences; 3) better access to health and social care; and 4) targeting multiple risk factors. These priorities informed preliminary design interventions. The final choice of intervention was agreed by consensus, informed by consideration of the gap in evidence and local service provision, and availability of robust data. This shaped a co-produced decision support tool to improve secondary prevention after stroke for further development.<h4>Conclusions</h4>Stakeholder engagement to identify data-driven solutions is feasible but requires resources. While a number of potential interventions were identified, the final choice rested not just on stakeholder priorities but also on data availability. Further work is required to evaluate the impact and implementation of data-driven interventions for long-term stroke survivors.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0177102&type=printable
spellingShingle Euan Sadler
Talya Porat
Iain Marshall
Uy Hoang
Vasa Curcin
Charles D A Wolfe
Christopher McKevitt
Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.
PLoS ONE
title Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.
title_full Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.
title_fullStr Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.
title_full_unstemmed Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.
title_short Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.
title_sort shaping innovations in long term care for stroke survivors with multimorbidity through stakeholder engagement
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0177102&type=printable
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